Provider Demographics
NPI:1992939961
Name:RETTINGER, KATIE J (MPT)
Entity type:Individual
Prefix:MS
First Name:KATIE
Middle Name:J
Last Name:RETTINGER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2077 BRODHEAD RD
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-4962
Mailing Address - Country:US
Mailing Address - Phone:724-375-9222
Mailing Address - Fax:724-375-9224
Practice Address - Street 1:2077 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-4962
Practice Address - Country:US
Practice Address - Phone:724-375-9222
Practice Address - Fax:724-375-9224
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011249L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist